Susceptibility‐weighted imaging in malignant melanoma brain metastasis

Schwarz, Dániel; Niederle, Thomas; Münch, Philipp; Hielscher, Thomas; Hassel, Jessica C.; Schlemmer, Heinz Peter; Platten, Michael; Winkler, Frank; Wick, Wolfgang; Heiland, Sabine; Delorme, Stefan; Bendszus, Martin; Bäumer, Philipp; Breckwoldt, Michael O.

doi:10.1002/jmri.26692

Cited by 14 publications

(12 citation statements)

References 31 publications

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“…In the case of brain metastases from systemic melanoma or breast cancer, T1-Gd has been shown to be better than other modalities (15,20). Moreover, in direct comparison with T1-Gd for detecting melanoma metastases, SWI-U has shown no diagnostic advantage (21). To our knowledge, the present study is the first one to prospectively evaluate the added value of SWI-Gd for the potential detection of brain metastases.…”

Section: Discussionmentioning

confidence: 79%

Recognition of Brain Metastases Using Gadolinium-Enhanced SWI MRI: Proof-of-Concept Study

et al. 2020

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Background and purpose: SWI MRI, a T2 * -dominant MRI sequence with T1 shine-through effect, uses intrinsic structural susceptibility to create enhancement among brain structures. We evaluated whether gadolinium-enhanced SWI (SWI-Gd) improves brain metastasis detection in combination with other MRI sequences.Materials and methods: MRI images of 24 patients (46 studies) were prospectively acquired using a 1.5-T scanner. T1-weighted, unenhanced SWI (SWI-U) and SWI-Gd were evaluated blindly to clinical features by two board-certified radiologists.Results: SWI-Gd revealed more significant metastatic lesions than either T1-Gd or SWI-U (p = 0.0004 for either comparator sequence). Moreover, SWI-Gd revealed more lesions only for those patients with ≤5 lesions on T1-Gd (n = 30 studies from 16 patients; p = 0.046). Performing SWI-Gd added <5 min of scanning time with no further additional risk.Conclusions: Our findings suggest that, when added to T1-Gd and other common sequences, SWI-Gd may improve the diagnostic yield of brain metastases with only a few extra minutes of scanning time and no further risk than that of a regular gadolinium-enhanced MRI.

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Section: Discussionmentioning

confidence: 79%

Recognition of Brain Metastases Using Gadolinium-Enhanced SWI MRI: Proof-of-Concept Study

et al. 2020

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“…This was first reported by Gaviani et al on T2 * -weighted imaging in three malignant melanoma patients (52). However, later studies analyzing the fate of isolated cerebral SWI artifacts in larger patient cohorts over time could not confirm the hypothesis that such "isolated SWI signals" would eventually evolve into overt brain metastases (53,54). Indeed, these studies showed that SWI signal losses without corresponding signal changes on standard sequences remained constant over time.…”

Section: Swi In Melanoma Brain Metastasesmentioning

confidence: 89%

“…The SWI signal drop remains as a remnant of the preexisting metastasis (iv). Adapted from Schwarz et al (54).…”

Section: Swi In the Assessment Of Treatment Responsesmentioning

confidence: 99%

“…brain metastases as compared to melanoma patients without metastatic brain disease (54). Of those patients, only patients after radiotherapy showed an increased number of such artifacts indicating that these findings did not constitute vital tumor tissue but may rather represent either non-specific microbleedings or radiotherapy-related parenchymal damage (56) which are both well-known phenomena in patients after radiotherapy of the brain (57).…”

Section: Swi In the Assessment Of Treatment Responsesmentioning

confidence: 99%

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Clinical Value of Susceptibility Weighted Imaging of Brain Metastases

2020

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MRI is used for screening, initial diagnosis and follow-up of brain metastases. Multiparametric MRI protocols encompass an array of image sequences to depict key aspects of metastases morphology and biology. Given the recent safety concerns of Gd-administration and the retention of linear Gd-agents in the brain, non-contrast sequences are currently evaluated regarding their diagnostic value for brain imaging studies. Susceptibility weighted imaging has been established as a valuable clinical and research tool that is heavily used in clinical practice and utilized in diverse pathologies ranging from neuroinflammation, neurovascular disease to neurooncology. We review the value of SWI in the field of brain metastases with an emphasis on its role in early diagnosis, determination of the primary tumor entity, treatment monitoring and discuss therapy-associated changes that can affect SWI. We also review recent insights on the role of "isolated SWI signals" and the controversy on the specificity of SWI for the early detection of brain metastases.

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“…37 These changes could be evaluated on SWI following SRS which allow for the assessment of treatment response along with T1 post-contrast images. 38,39 The purpose of our study was to extend previous work and evaluate the longitudinal change of intratumoral susceptibility signal (ITSS) on highresolution SWI as an adjunctive imaging tool to evaluate treatment response of brain metastasis following stereotactic radiosurgery. Our hypothesis is that this approach could help further stratification of the patients and guide clinical decision making.…”

Section: Introductionmentioning

confidence: 99%

High-Resolution Intratumoral Susceptibility Signal (ITSS) as an Adjunctive Imaging Tool in the Evaluation of Treatment Response of Brain Metastases Following Stereotactic Radiosurgery

Nada¹,

Mahmoud

Ahsan

et al. 2022

MRAJ

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Purpose: To evaluate the longitudinal change of intra-tumoral susceptibility signal (ITSS) on high-resolution SWI as an adjunctive imaging tool to evaluate treatment response of brain metastasis following stereotactic radiosurgery. This approach will allow further stratification of the patients and guide clinical decision making. Methods: An IRB approved retrospective study included 63 brain metastatic lesions within 49 patients (33 females and 16 males) who have undergone stereotactic radiosurgery with at least one follow-up MRI and available clinical data. The average age was 63.17 years (±1.48, ranged from 34-83 years). The longitudinal change in ITSS was categorized into 3 groups; increased, stable and decreased. The treatment response of each lesion was evaluated according to the longitudinal change in size, enhancement and susceptibility at the baseline and follow-up MRIs. Chi-square test was used to compare differences in categorical variables. Receiver operating characteristics (ROC) curve was used to evaluate the accuracy of including longitudinal change in ITSS with size and enhancement pattern in determining the treatment response following SRS. Results: Our results demonstrated higher sensitivity and specificity when including longitudinal change in ITSS with size and enhancement for the evaluation of the treatment response of brain metastatic lesions treated with SRS. There was statistically significant difference between the different ITSS and enhancement patterns at baseline and follow-up MRIs (Wilcoxon Signed Ranks Test (p = .000, and .003) respectively. The multiparametric analysis of the longitudinal change in size, contrast enhancement, and ITSS in the evaluation of treatment response in the follow-up MRIs, showed that the sensitivity and specificity significantly improved (AUC 0.953). Conclusion: High resolution SWI can contribute as an imaging biomarker with supplemental information for monitoring treatment and predicting treatment response. High resolution SWI can complement the standard contrast enhanced T1 images to evaluate treatment response with a multiparametric MRI approach.

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Susceptibility‐weighted imaging in malignant melanoma brain metastasis

Cited by 14 publications

References 31 publications

Recognition of Brain Metastases Using Gadolinium-Enhanced SWI MRI: Proof-of-Concept Study

Recognition of Brain Metastases Using Gadolinium-Enhanced SWI MRI: Proof-of-Concept Study

Clinical Value of Susceptibility Weighted Imaging of Brain Metastases

High-Resolution Intratumoral Susceptibility Signal (ITSS) as an Adjunctive Imaging Tool in the Evaluation of Treatment Response of Brain Metastases Following Stereotactic Radiosurgery

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